Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Pernille Tine Jensen, Aarhus University, Denmark
- Second opponent: Associate Professor Henrik Falconer, Karolinska institutet, Sweden
- Third member and chair of the evaluation committee: Professor Ingvild Vistad, University of Oslo
Chair of the Defence
Professor II Anne Flem Jacobsen, University of Oslo
Principal Supervisor
Associate Professor Ane Gerda Zahl Eriksson, University of Oslo
Summary
Endometrial carcinoma is the most common gynecological cancer in Norway, with approximately 800 women diagnosed yearly. Treatment consists of removal of the uterus with ovaries, and, for many patients, the removal of lymph nodes in order to stage the cancer correctly. Previously, staging was done by a thorough lymphadenectomy, removing several lymph nodes at once. For the past 15 years, the sentinel lymph node biopsy has been introduced, where only the lymph nodes with the highest probability of harboring metastasis are removed.
The aim of this thesis was to evaluate the effects of the sentinel lymph node biopsy implementation at the Norwegian Radium Hospital, which covers about 50% of the country’s population. Sentinel lymph node biopsy has since July 2017 been the preferred nodal assessment method at this institution.
After translation of a lymphedema-related questionnaire, the study group found that patients who underwent sentinel lymph node biopsy reported fewer lymphedema complaints compared to patients who underwent with lymphadenectomy. They also found that patients with lymphedema reported lower quality of life compared to patients without lymphedema.
The PhD project included a cost-effectives analysis by creating an economic model. The authors found that the implementation of sentinel lymph node biopsy was cost-saving and improved patient reported quality of life.
The proportion of surgically staged patients increased after the implementation of sentinel lymph node biopsy and the type of nodal assessment method was not associated with nodal metastasis.
In conclusion, this thesis shows that the implementation of sentinel lymph node biopsy as a staging procedure for women with endometrial carcinoma has led to less lymphedema as well as a better quality of life. In addition, the implementation has been cost-saving, while the detection rate of metastatic lymph nodes has remained stable.
Additional information
Contact the research support staff.